Article Text

PDF
Original research
The bihemispheric posterior interior cerebellar artery: anatomic variations and clinical relevance in 11 cases
  1. Andrew P Carlson,
  2. Ali Alaraj,
  3. Reza Dashti,
  4. Victor A Aletich
  1. Department of Neurosurgery, Neuropsychiatric Institute (MC799), University of Illinois Hospital and Health Sciences System, College of Medicine, Chicago, Illinois, USA
  1. Correspondence to Dr A Alaraj, Department of Neurosurgery, Section of Endovascular Neurosurgery, Neuropsychiatric Institute (MC799), University of Illinois Hospital and Health Sciences System, College of Medicine, 912 S Wood St, Chicago, IL 60612-7329, USA; alaraj{at}uic.edu

Abstract

Purpose Although the anatomic course of the posterior interior cerebellar artery (PICA) is variable, it is thought to be very rare for the artery to cross midline, with an estimated incidence of 0.1%. Bihemispheric PICA crosses midline and typically serves both PICA territories.

Methods We present 11 cases of bihemispheric PICA discovered from retrospective angiogram review, the largest to date reported in the literature.

Results Five cases were the typical bihemispheric PICA pattern, three were bihemispheric with distal vertebral hypoplasia, two cases were the vermian type, and one was atypical, with the PICA feeding a contralateral cerebellar arteriovenous malformation (AVM). The branching point to the contralateral hemisphere always occurred distal to the ascending tonsillar loop and all true bihemispheric variants had contralateral PICA aplasia.

Conclusions The true incidence of this variant may be much higher than previously thought (3.6% in the current series), and has relevance for cerebrovascular disease, including aneurysm, AVM, and ischemic stroke. Neuroradiologists, neurologists, and neurosurgeons should be aware of this potential variant.

  • Angiography
  • Posterior fossa
  • Vascular Malformation

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.